Provider Demographics
NPI:1548212285
Name:KATER, GABRIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:
Last Name:KATER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12798 W FOREST HILL BLVD
Mailing Address - Street 2:SUIT 301A
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4750
Mailing Address - Country:US
Mailing Address - Phone:561-795-9150
Mailing Address - Fax:561-798-7700
Practice Address - Street 1:12798 W FOREST HILL BLVD
Practice Address - Street 2:SUIT 301A
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4750
Practice Address - Country:US
Practice Address - Phone:561-795-9150
Practice Address - Fax:561-798-7700
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 709502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
31287Medicare ID - Type Unspecified
FL31287Medicare PIN
G 0423Medicare UPIN